The event of patient death inevitably invites a feeling of remorse and grief among the caregivers. Constant or prolonged contact with patients creates a sense of bonding between the patients and the caregiver. This mutual bond develops and grows with time. When a patient dies eventually, there is a sudden feeling of loss by the nurse. Though nurses’ characteristics vary, a great number of nurses who take care of patients in death beds experience this feeling on occasions of patient death. There is a dearth of research as to the exact nature of characteristics that are inherent in the nurses who experience a feeling of loss and grief, and what symptoms are common among such caregivers.
The study design was both qualitative and quantitative research design. Both designs would be used to assess aspects of effects of grief resulting from loss of patients on the nursing staff (Creswell, 2004). It is suggested that the success of this investigation would be improved by the combined effect of both quantitative and qualitative methods. It is important to quantify the prevalence of this situation and at the same time, explore the depth of the effect and the characteristics of the nurses who are involved through qualitative design.
The role of the researcher was designing, administration and the interpretation of results from the study. The research may be exposed to selection bias. This is on account of the fact that the sample size, 10 nurses was a small number that may not be quite representative.
The study utilized random sampling was used to select assisted living care centers. Random sampling is important because it eliminates the possibility of bias, and the assisted living centers was selected because of the increased prospect of contact with nurses who have dealt with grief. The participants were nurses between 25 and 55 years in assisted living centers.
Hypothesis formulated for this study was that many nurses are affected by grief when people under their care with whom they have established an emotional bond die.
B. the data collection methods were used included conducting interviews and administration of questionnaires.
C. In addition to the questionnaires, other tools which were used included Marwit-Meuser Caregiver Grief Inventory (MM-CGI), an instrument used to assess pre-death grief among nurses who take care of cancer patients. Additionally, another instrument called brief grief questionnaire, a 5-item tool for self-reporting the symptoms of grief across different cultures was also used. These data collection tools appear in the appendices section. D. The data that was obtained was both quantitative and qualitative data. However, the data were correlated and synchronized for interpretation and concrete conclusions.
E. Pre-interviews were conducted with each potential participant in order to find out their experiences with grief. This led to the screening and determination of which participants who were qualified to provide information that was required on grief. Finally, one-on-one processing with the selected participants was then done. The tools for collection of data will be administered in the assisted care centers where the respondents will be contacted. The collection of data began after the tools had been tested for effectiveness and modifications done as appropriate.
The data was then presented using data presentation techniques such as graphs and charts as well as tables. It was then cleaned, categorized and analyzed in order to be able to find out patterns. Conclusions were then drawn from it and hypothesis were also tested. Recommendations based on the results were then proposed in order to guide policy.
Bougere,M.H.(2013). Culture, Grief and Bereavement: Applications for Clinical Practice.
Creswell, J. W. (2004). Research design: Qualitative and quantitative approaches. Thousand
Oaks, CA: Sage.
Lenart,S.B., Bauer,C.G.,Brighton,D.D., Johnson, J.J.,& Stringer, T.M. (1994). Grief Support
for Nursing Staff in the ICU. Journal for Nurses in Professional Development,
Wilson, J.,& Kirshbaum, M.(2011). Effects of patient death on nursing staff: A literature review.
British Journal of Nursing, 20, 559-563
- MM Caregiver Grief Inventory - Short Form Thomas M. Meuser, Ph.D., University of Missouri – St. Louis(http://alzheimer.wustl.edu/about_us/PDFs/MM-CGI%20Short%20Form.pdf)
Samuel J. Marwit, Ph.D., University of Missouri-St. Louis (Emeritus)
with progressive dementia (e.g., Alzheimer’s disease). Read each statement carefully, then decide how much you agree
or disagree with what is said. Circle a number 1-5 to the right using the answer key below (For example 5 = Strongly
Agree). It is important that you respond to all items so that the scores are accurate. Scoring rules are listed below.
1 = Strongly Disagree // 2 = Disagree // 3 = Somewhat Agree // 4 = Agree // 5 = Strongly Agree
1 I’ve had to give up a great deal to be a caregiver. 1 2 3 4 5
2 I feel I am losing my freedom. 1 2 3 4 5
3 I have nobody to communicate with. 1 2 3 4 5
4 I have this empty, sick feeling knowing that my loved one is “gone”. 1 2 3 4 5
5 I spend a lot of time worrying about the bad things to come. 1 2 3 4 5
6 Dementia is like a double lossI’ve lost the closeness with my loved one and
connectedness with my family. 1 2 3 4 5 C
7 My friends simply don’t understand what I’m going through. 1 2 3 4 5
8 I long for what was, what we had and shared in the past. 1 2 3 4 5
9 I could deal with other serious disabilities better than with this. 1 2 3 4 5
10 I will be tied up with this for who knows how long. 1 2 3 4 5
11 It hurts to put her/him to bed at night and realize that she/he is “gone” 1 2 3 4 5
12 I feel very sad about what this disease has done. 1 2 3 4 5
13 I lay awake most nights worrying about what’s happening and how I’ll manage
tomorrow. 1 2 3 4 5
14 The people closest to me do not understand what I’m going through. 1 2 3 4 5
15 I’ve lost other people close to me, but the losses I’m experiencing now are
much more troubling. 1 2 3 4 5
16 Independence is what I’ve lostI don’t have the freedom to go and do what I
want. 1 2 3 4 5
17 I wish I had an hour or two to myself each day to pursue personal interests. 1 2 3 4 5
18 I’m stuck in this caregiving world and there’s nothing I can do about it. 1 2 3 4 5
Self-Scoring Procedure: Add the numbers you circled
Use the letters to the right of each score to guide you.
Personal Sacrifice Burden (A Items) = __________
(6 Items, M = 20.2, SD = 5.3, Alpha = .83, n = 292)
Heartfelt Sadness & Longing (B Items) = __________
(6 Items, M = 20.2, SD = 5.0, Alpha = .80, n = 292)
Worry & Felt Isolation (C Items) = __________
(6 Items, M = 16.6, SD = 5.2, Alpha = .80, n = 292)
Total Grief Level (Sum A + B + C) =__________
(18 Items, M = 57, SD = 12.9, Alpha = .90, n = 292)
Plot your scores using the grid to the right. Make an “X”
nearest to your numeric score for each sub-scale
heading. Connect the X’s. This is your grief profile.
Discuss this with your support group leader or counselor.
- Brief Grief Questionnaire( from http://www.bostongrief.com/id6.html)
1. How much are you having trouble accepting the death of ______________?
Not at all 0
A lot 2
2. How much does your grief still interfere with your life?
Not at all 0
3. How much are you having images or thoughts of _____________ when s/he died or other thoughts about the death that really bother you?
Not at all 0
4. Are there things you used to do when ______ was alive that you don’t feel comfortable doing anymore, that you avoid? Like going somewhere you went with him/her, or doing things you used to enjoy together? Or avoiding looking at pictures or talking about _________? How much are you avoiding these things?
Not at all 0
5. How much are you feeling cut off or distant from other people since _________
died, even people you used to be close to like family or friends?
Not at all 0
Hospital name.. Age..
Current position.. Number of years in practice..
Primary area of specialization Ethnic background
- Impact of loss of the patient
The following questions are meant to aid in helping you think the effect of the loss on your self as well as your colleagues. You may think of a patient you lost which had a challenging effect on you.